Dr. Clarke's Medical Notes on Climnte, Diseases, 6^c. 53 



cles. By a little future attention in guarding against the known 

 exciting causes of inflammation, these may long, and perhaps 

 for life, remain in a state of quiescence. By such measures, 

 and a strict adherence to the other means most proper for 

 strengthening the constitution, and by acquiring habits calcu- 

 lated to inure the body to the cold and inequalities of its native 

 climate, (among which I consider the habitual use of the cold 

 bath as pre-eminent,) 1 have no doubt that many lives might be 

 saved'-'. When, however, suppuration has actually taken place 

 in the substance of the tubercles, my opinion is, that little or no 

 benefit is to be expected from a change of climate in the cure 

 of the disease ; and further, that by the great and numerous in- 

 conveniences and discomforts of so long a journey, the fatal ter- 

 mination of it is more frequently accelerated than protracted. 

 That this is very frequently the case in the very advanced stages 

 of the disease, such as I have frequently met with on the con- 

 tinent shortly after their arrival from England, I have no manner 

 of doubt. 



" There is still a circumstance connected with the object of this 

 essav, on which I must beg leave to say a few words, I mean the 

 state in which many consumptive patients are sent abroad. In 

 the remarks 1 am about to make, I beg explicitly to state that I 

 have no intention to censure any one. I am aware of the diffi- 

 cult situation in which a medical man is placed , when called to 

 decide upon a point where he must often find his information de- 

 ficient, and where the wisest and best-informed mav err. 



" During my residence on the continent, 1 have had frequent 

 occasions to remark with surprise the very advanced stages of the 

 disease in which many of our c<)iisun>ptive patients were sent 

 abroad. This is the more remarkable, as, however medical men 

 may differ about the propriety of sending such patients abroad in 

 the earlier, there surely ought to be no question about its im- 

 propriety in the latter stages. For my own part, I have seen 

 enough to convince me that it is not only a very nse'ess, but 

 often a very cruel thing to banish such patients from all the com- 

 forts of home, and send them forth to undertake a long journey 

 through a foreign country, deprived probably of all they hold 

 dearest to them, and without tliose thousand nameless comforts 

 by which the watchful care of friends may cheer even the last 



* Sec Author's Thesis " De Frigoris EfTectihus in Corpus vivum," pub- 

 lif^hcd at Edinburijh in 1817, for detailed observations on the inHucnce of 

 the cold biith in stren;;thuning the body and eiiabling it to bear cold. 



It is the opinion of son\e medical men, tliat cold alone is sufficient for the 

 production of tubercles in the lunjjs, and certainly it is a common cause of 

 inflammation and suppuration of them. — Dr. IJroussais's observations of th« 

 comparative rarity of pulmonary consumi)lions among the Trench troops 

 alter their entering Italy is deserving of remark. 



period 



